Abstract
SLAP lesions can occur as a result of two discreet mechanisms. An acute SLAP tear may result from a traumatic superior compression force during a fall or a traumatic inferior pull to the arm. A chronic SLAP tear, in contrast, may result from repetitive overhead activity. Such overuse and repetitive microtrauma is commonly seen in overhead athletes. Clinical presentation of an acute SLAP tear is usually a sudden onset pain following an acute traumatic episode versus an insidious onset of symptoms in a chronic tear, which is exacerbated by repetitive overhead movements.
An acute tear may well be associated with an extensive labral injury, whereas a chronic labral tear is commonly more degenerative in nature and associated with partial-thickness rotator cuff tears of the posterior superior quadrant. An MRI arthrogram remains the gold standard imaging investigation for both acute and chronic tears, with arthroscopic assessment being the most accurate.
Whereas an acute SLAP tear is best treated with early arthroscopic labral repair, including concomitant repair of damaged structures, a chronic SLAP tear is best managed with a trial of nonoperative treatment followed by surgery if symptoms persist. Surgery is in the form of either a SLAP repair or a biceps tenodesis.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Andrews JR, Carson WG, McLeod WD. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med. 1985;13(5):337–41.
Bigliani LU, Codd TP, Connor PM, Levine WN, Littlefield MA, Hershon SJ. Shoulder motion and laxity in the professional baseball player. Am J Sports Med. 1997;25(5):609–13.
Boileau P, Parratte S, Chuinard C, Roussanne Y, Shia D, Bicknell R. Arthroscopic treatment of isolated type II SLAP lesions: biceps tenodesis as an alternative to reinsertion. Am J Sports Med. 2009;37(5):929–36.
Borrero CG, Casagranda BU, Towers JD, Bradley JP. Magnetic resonance appearance of posterosuperior labral peel back during humeral abduction and external rotation. Skeletal Radiol. 2010;39(1):19–26.
Burkhart SS, Morgan CD. The peel-back mechanism: its role in producing and extending posterior type II SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy. 1998;14(6):637–40.
D’Alessandro DF, Fleischli JE, Connor PM. Superior labral lesions: diagnosis and management. J Athl Train. 2000;35(3):286–92.
Edwards SL, Lee JA, Bell JE, et al. Nonoperative treatment of superior labrum anterior posterior tears: improvements in pain, function, and quality of life. Am J Sports Med. 2010;38(7):1456–61.
Funk L, Snow M. SLAP tears of the glenoid labrum in contact athletes. Clin J Sport Med. 2007;17(1):1–4.
Jost B, Zumstein M, Pfirrmann CWA, Zanetti M, Gerber C. MRI findings in throwing shoulders: abnormalities in professional handball players. Clin Orthop Relat Res. 2005;434:130–7.
Kanatli U, Ozturk BY, Bolukbasi S. Anatomical variations of the anterosuperior labrum: prevalence and association with type II superior labrum anterior-posterior (SLAP) lesions. J Shoulder Elbow Surg. 2010;19(8):1199–203.
Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med. 1998;26(2):325–37.
Knesek M, Skendzel JG, Dines JS, Altchek DW, Allen AA, Bedi A. Diagnosis and management of superior labral anterior posterior tears in throwing athletes. Am J Sports Med. 2013;41:444–60.
Morgan CD, Burkhart SS, Palmeri M, Gillespie M. Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy. 1998;14(6):553–65.
Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ. SLAP lesions of the shoulder. Arthroscopy. 1990;6(4):274–9.
Wilk KE, Meister K, Andrews JR. Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports Med. 2002;30(1):136–51.
Zhang AL, Kreulen C, Ngo SS, Hame SL, Wang JC, Gamradt SC. Demographic trends in arthroscopic SLAP repair in the United States. Am J Sports Med. 2012;40(5):1144–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Funk, L., Monga, P. (2015). SLAP Lesions Part II: Acute Lesion Versus Chronic Lesion Resulting from Repetitive Motion (or Microtrauma). In: PARK, JY. (eds) Sports Injuries to the Shoulder and Elbow. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-41795-5_11
Download citation
DOI: https://doi.org/10.1007/978-3-642-41795-5_11
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-41794-8
Online ISBN: 978-3-642-41795-5
eBook Packages: MedicineMedicine (R0)